首诊眼科的前床突脑膜瘤临床分析

Clinical analysis of clinoidal meningioma primarily diagnosed by ophthahnologic examination

目的 探讨首诊眼科的前床突脑膜瘤的临床表现与特点。方法 对14例病例进行回顾性分析，对其临床表现、解剖特点、影像学特点、视野及VEP表现进行分析总结。结果 在首诊眼科的14例患者中，以视力下降为主要表现的共8例，占本组病例的57．14％；头疼、头晕为主7例，占50％：以动眼神经压迫症状为主3例，占21．4％；意外发现1例。7例行中心视野检查其表现与肿瘤压迫部位基本相符，6例行VEP检查全部表现异常；14例行MRI检查，均可见占位眭病变；9例CT检查者，有2例未查见占位性病变，MRI、CT两者联合有助于明确诊断。结论 对用眼疾病难以解释的视力减退和（或）眼肌麻痹的患者，应行头颅影像学检查排除有无颅内占位性病变，即使无明显眼底改变也应做视野检查，以避免漏诊。

Obieetive To investigate the ocular clinical manifestations and features of clinoidal meningioma primarily diagnosed by ophthalmologic examination. Methods 14 patients were retrospectively analyzed and their clinical manifestations, anatomical characteristic, features of imageology, manifestation of visual fields and VEP were summarized.Results Among the 14 cases,8 patients（57.14）%, went to see eye doctor with the chief complain of visual loss, 7 （50%） with dizziness and headache,3（21.4%） with limited ocular movement,and one case was found accidentally.Seven patients took visual field examination and the results were relatively consistent with the anatomical characteristics of the location of clinoidal meningioma.VEP was performed on six cases and the results were all anomaly. Fourteen patients underwent MRI and the result were all positive.However,two of the 9 patients who underwent CT scan did not show anomaly.Conelusious Patients who had visual loss and/or ophthalmoplegia,but could not be explained by eye disease,should take further examinations such as skull CT scan and/or MRI to exclude intracranial neoplasm.At the same time,visual field examination should also be taken to avoid misdiagnosis,even if no significantly change was found in fundus examination.